Hysterectomy surgery 'not always necessary'

Thousands of women have undergone the trauma of unnecessary hysterectomies, research suggests today.

A study of hysterectomy - the surgical removal of the womb - found that less invasive techniques for combating heavy periods might have prevented a significant proportion of such operations carried out in the mid-Nineties.

The Royal College of Obstetricians and Gynaecologists said the Department of Health should draw up national guidelines for doctors in light of the research and advances in medicine as "the availability of newer, less invasive techniques ... needs further consideration".

Hysterectomy is the most common major gynaecological operation with up to 100,000 carried out annually in Britain. Around 20 per cent of women have had the procedure by the age of 60 - a figure which has changed little during the last decade.

The study looked at 37,298 cases between 1994 and 1995. Its authors, from prestigious universities and hospitals across the UK, found nearly half of these (46 per cent) were performed on women complaining of heavy menstrual periods.

They indicate that in 50-75 per cent of cases, it would have been sufficient to remove the womb's lining, avoiding the need to remove the uterus. They write: "The use of these less-invasive techniques, certainly available at that time, might have prevented up to 75 per cent of these hysterectomies."

The study, published in the British Journal of Obstetrics and Gynaecology, also looked at complications depending on which surgical technique was used to remove the womb.

Fourteen deaths were reported within six weeks of surgery using the vaginal technique rather than the abdominal method which has the lowest risk for respiratory and cardiovascular complications.

A spokesman for the Royal College of Obstetricians and Gynaecologists said the study represents the most extensive description of surgical practice in relation to hysterectomy in the Nineties.

The spokesman said: "This is an important descriptive study of hysterectomy - who is having the operation, its benefits and its problems.

"The availability of newer, less invasive techniques for the treatment of heavy periods needs further consideration and both the Department of Health and National Institute for Clinical Excellence should consider the need for national guidelines for women and doctors."